19th August 2024

A 45-year-old man presents with sudden-onset vertigo, nausea and vomiting

A 45-year-old man presents with sudden-onset vertigo, nausea and vomiting. He reports that he has had a recent coryzal illness but has no other past medical history. He feels dizzy and as though the room is spinning. It is worse when he rotates his head to the right although still has the feeling to a lesser extent when sitting still. He has been unable to walk since the onset of the symptoms and has vomited numerous times in the department. He reports no change in his hearing. On examination, he has slurred speech, diplopia and there is an element of dysmetria. What is the gold standard investigation to identify the cause of this gentleman’s vertigo?

Select the SINGLE most appropriate option from the list below. Select ONE option only.